To compare the clinical effects and complications of traditional cage-titanium plate andzero-profile anchored spacer(ROI-C) combined with anterior cervical decompression and fusion internal fixation in the treatment of single-level cervical spondylotic myelopathy.

A total of 133 patients underwent anterior cervical disectomy and fusion surgery at Zhujiang Hospital, Southern Medical Universityfrom July 2017 to July 2019 were included in this prospective study. They were divided into either atitanium plate group (n=69) or a ROI-C group (n=64) according to the use of traditional cage combined with titanium plate or ROI-C cage during the surgery. The operative time and intraoperative blood loss were compared between the two groups. Visual analogue scale (VAS) score, Japanese Orthopaedic Association (JOA) score, and neck disability index (NDI) score were used to evaluate the improvement of clinical symptoms.Cervical curvature and intervertebral height were measured by cervical X-ray. Postoperative dysphagia was assessed by Bazaz score, adjacent segment degeneration was assessed by Kellgren's standard, and intraoperative and postoperative complications were recorded.

All the 133 cases were followed for 24 months. Operation time was shorter in the ROI-C group than that in the titanium plate group [(60.9±18.2) min vs (75.4±20.6) min, P＜0.05], However, there was no significant difference in intraoperative blood loss or average length of hospital stay between the two groups (P＞0.05). Cervical curvature, intervertebral height, VAS score, JOA score, and NDI score were all better at 3 d, 3 months, 12 months, and 24 months after surgery than those before surgery (P＜0.05), but there was no statistical significance at any time point between the two groups (P＞0.05). There was no significant difference in the incidence of postoperative dysphagia (4.35% vs 3.13%, P＞0.05) or adjacent segment degeneration (5.80% vs 4.69%, P＞0.05) between the two groups.

For single-level cervical spondylotic myelopathy, anterior cervical decompression, bone grafting, and internal fixation with traditional cage-titanium plate and ROI-C fusion apparatus can achieve good clinical results. The use of ROI-Ccan shorten the operative time, but does not significantly reduce the incidence of postoperative dysphagia and adjacent segment degeneration.